Remote | Healthcare Denials & Appeals Review Consultant — Up to $70/hour

24-Mag • New York, NY

16h • $70 - $70 • Remote

About The Position

We are sharing a specialised part-time consulting opportunity for United States-based healthcare revenue cycle professionals experienced in denials management, appeals operations, payer denial analysis, clinical and technical appeals, denial prevention, revenue recovery, and healthcare billing workflows. This role supports current and upcoming remote consulting opportunities focused on AI-assisted denials management evaluation, appeal content review, payer denial workflow assessment, root cause analysis, and high-quality project execution. Selected professionals will apply denials and appeals expertise to evaluate AI-generated appeal letters, review denial prevention recommendations, identify payer-specific issues, and provide structured feedback based on detailed project criteria.

Requirements

• 5+ years of experience in denials management, appeals, revenue cycle operations, payer collections, or healthcare claims resolution.
• At least 2 years of experience in a management, team lead, supervisor, or operational oversight role.
• Deep knowledge of CARC/RARC denial codes, payer denial patterns, and appeal strategies across commercial, Medicare, and Medicaid payers.
• Strong understanding of clinical and technical appeal processes, including peer-to-peer reviews and external reviews.
• Experience with denial analytics platforms, revenue cycle reporting tools, EHR systems, and billing platforms.
• Exceptional written and verbal English communication skills.
• High attention to detail and ability to evaluate appeal quality, denial logic, and AI-generated revenue cycle content.
• Ability to work independently in a remote, project-based environment.
• Professional background in healthcare revenue cycle operations, denials management, appeals, billing operations, coding, clinical documentation, payer follow-up, or claims resolution is highly relevant.
• United States-based professionals are required for this opportunity.

Nice To Haves

• Experience in hospital, physician group, health system, payer-facing, or multi-payer revenue cycle environments may be especially valuable.
• Practical experience with denial workqueues, appeal calendars, payer portals, billing systems, denial analytics tools, and revenue recovery workflows may support project fit.
• Formal education in healthcare administration, business, finance, health information management, nursing, coding, or a related field may be relevant depending on project scope.
• CPC, CCS, CRCR, CHFP, or similar coding, revenue cycle, or healthcare finance credential.
• Experience with AI-assisted denial management platforms or revenue cycle tools such as Waystar, Experian Health, Nthrive, or similar systems.
• Background in complex clinical appeals, including medical necessity, experimental or investigational, level-of-care, or authorization-related denials.
• Familiarity with AI tools and comfort evaluating AI-generated appeal, denial, and revenue cycle content.
• Experience developing denial reduction action plans, payer-specific appeal strategies, SOPs, or performance reports for revenue cycle leadership.

Responsibilities

• Review denials management workflows involving claim denial identification, categorization, resolution, and appeal strategy.
• Evaluate AI-generated appeal letters, denial root cause analyses, and denial prevention recommendations for accuracy and effectiveness.
• Assess clinical and technical appeal content across commercial, Medicare, Medicaid, and managed care payers.
• Identify weak appeal logic, missing documentation, unsupported arguments, payer-specific issues, or incomplete denial resolution strategies.
• Analyze denial trends by payer, denial code, denial category, and operational root cause.
• Review outputs involving CARC/RARC codes, payer denial patterns, appeal deadlines, reimbursement recovery, and claim resolution workflows.
• Evaluate denial management KPIs such as denial rates, appeal overturn rates, revenue recovery, days in accounts receivable, and write-off trends.
• Assess whether denial prevention recommendations are practical, compliant, and aligned with revenue cycle operations.
• Annotate AI-generated denial and appeal outputs and provide structured feedback to support quality improvement.
• Evaluate content for alignment with payer appeal requirements, CMS regulations, timely filing deadlines, and internal revenue cycle standards.
• Explain review decisions clearly, consistently, and with strong denials management judgment.
• Follow detailed task instructions, quality criteria, and project-specific review guidelines accurately.

Benefits

• Competitive hourly compensation
• Flexible scheduling
• Competitive rates of up to $70 per hour depending on denials management experience, appeals expertise, management background, and project scope
• Weekly payments via Stripe or Wise

What This Job Offers

• Job Type: Part-time
• Career Level: Mid Level
• Education Level: No Education Listed